Annals of Surgical Oncology

, Volume 21, Issue 5, pp 1468–1473

Ovarian Cancer in BRCA Mutation Carriers: Improved Outcome After Intraperitoneal (IP) Cisplatin

  • Maryann Kwa
  • Susan Edwards
  • Andrea Downey
  • Elsa Reich
  • Robert Wallach
  • John Curtin
  • Franco Muggia
Regional Cancer Therapies

DOI: 10.1245/s10434-013-3277-y

Cite this article as:
Kwa, M., Edwards, S., Downey, A. et al. Ann Surg Oncol (2014) 21: 1468. doi:10.1245/s10434-013-3277-y

Abstract

Background

Ovarian cancer arising in women with BRCA mutations is known to have a more favorable outcome and to be more responsive to platinum-based regimens than in those without a hereditary background. We analyze our previously published intraperitoneal (IP) studies in relation to BRCA mutation status and update their outcomes.

Methods

Among 62 patients with ovarian cancer enrolled in IP platinum doublet studies in clinical trials (with etoposide (n = 18), with floxuridine (n = 30), and with topotecan (n = 14)), a deleterious BRCA mutation was eventually identified in 10 patients. The outcomes in these BRCA mutation carriers are described and compared with survival of others in respective trials.

Results

Ten patients that were confirmed to have BRCA mutations—all with high-grade and stages IIC to IV disease—survived a median of 10 years (range: 4–18+) after receiving IP cisplatin-based regimens. Two continue with no evidence of disease since their IP treatment, while four others remain alive with recurrences after 8, 9, 10, and 11 years, respectively.

Conclusions

This experience suggests that IP cisplatin leads to favorable long term outcomes in advanced ovarian cancer in women with defective homologous recombination (i.e., with deleterious BRCA mutations). Whether such cisplatin dose-intensification from IP relative to (intravenous) IV drug administration leads to superior results in these mutation carriers requires further study.

Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Maryann Kwa
    • 1
  • Susan Edwards
    • 2
  • Andrea Downey
    • 1
  • Elsa Reich
    • 1
  • Robert Wallach
    • 1
  • John Curtin
    • 1
  • Franco Muggia
    • 1
  1. 1.New York University Medical CenterNYU Cancer InstituteNew YorkUSA
  2. 2.University of Southern California Medical CenterNorris Cancer CenterLos AngelesUSA